State-owned Hospitals Research Articles

PT Rumah Sakit PELNI is a state-owned hospital located in West Jakarta. This study aims to determine the partial and simultaneous effects of the work environment and work discipline on employee performance. The type of research data used is quantitative, utilizing multiple linear regression analysis, with data processed using SPSS. This study employed a non-probability sampling approach to select 54 employees as the population. The data sources used include primary data such as observations and questionnaires, as well as secondary data from literature studies through books and journals. The results of this study indicate that the work environment has a positive and significant partial effect on employee performance. The work discipline variable also has a positive and significant partial effect on employee performance. Furthermore, the work environment and work discipline variables have a simultaneous and significant effect on employee performance. Based on the R-Square (R²) determination coefficient test, the work environment and work discipline contribute 72.1% to employee performance.

Objective: The object of the article is to review the clinical trials conducted in Bulgarian state-owned hospitals during the COVID-19 pandemic (2019-2022). Material and methods: We have created a unique database of clinical trials from public registers of competent authorities. Our review is based on the content of the protocols of 550 clinical trials conducted in all 62 state-owned hospitals. Results: The number of clinical trials is decreasing, as is the number of trial centres in state-owned hospitals. The clinical trial sector will not go back to pre-pandemic levels, as we predict for the year after the pandemic (2023). In the new reality, reduced budget and declined state funding, the attitudes of state-owned hospitals and patients are shifting towards the benefits of clinical trials. The primary motive for state-owned hospitals to conduct clinical trials is not revenues, but rather access to new drugs and treatment methods. Conclusions: We explain the decline in the number of clinical trials with the national measures addressed to the challenges of the COVID-19 pandemic. The therapeutic area of clinical trials is tailored to the local demographic trend and is not aligned to the most common diseases in Bulgaria. Therefore, Bulgaria is more of a market for the launching tested drugs than a market for testing new drugs.

Abstract: Contracting private providers in public health systems poses regulatory challenges, especially regarding the design of the payment model for services. This article examines the payment system for social organizations contracted to run state-owned hospitals (Organizações Sociais de Saúde - OSS) in the Brazilian State of São Paulo. The research is based on the literature on hospital care financing in public health systems and examined contracts between the government and OSS, as well as semi-structured interviews with managers and technicians from the State Health Department. The aim was to understand the rationale of the payment system and the basis for decisions to transfer resources to the OSSs. The research indicates that the arrangement designed for the economic and financial regulation of OSS has significant flaws due to the lack of consistent references regarding the cost and complexity of the care provided by the hospitals. The absence of parameters results in weaknesses in the criteria guiding the transfer of resources to OSS, impairing the effectiveness of monitoring and control of the provision of services by the state.

Resumo A contratação de provedores privados em sistemas públicos de saúde envolve consideráveis desafios regulatórios, particularmente com relação ao desenho do modelo de pagamento dos serviços. Neste artigo, examina-se a sistemática de remuneração de hospitais geridos por Organizações Sociais de Saúde (OSS) sob contratos de gestão firmados com o governo do estado de São Paulo à luz da literatura que trata do financiamento do cuidado hospitalar em sistemas públicos de saúde. Foram analisados contratos de gestão de hospitais administrados por OSS e realizadas entrevistas semiestruturadas com gestores e técnicos da Secretaria Estadual da Saúde (SES). Buscou-se compreender a lógica do modelo de remuneração e a base das decisões de repasse de recursos às entidades gerenciadoras. A pesquisa indicou que o arranjo elaborado para a regulação econômico-financeira das OSS apresenta falhas importantes devido à falta de referências consistentes acerca do custo e da complexidade do cuidado prestado pelos hospitais. A ausência de parâmetros resulta em fragilidade dos critérios norteadores das transferências de recursos às OSS, prejudicando a efetividade do monitoramento e do controle da provisão de serviços pela gestão estadual.

This research aims to assess the implementation of health information systems (HIS) in state-owned hospitals in Ghana, particularly focusing on teaching, regional, district, and quasi-government hospitals. The purpose is to evaluate the HIS application, training, data protection measures, internal system communication within hospitals, and the impact of internet connectivity and electricity supply on HIS adoption. The study employed a quantitative research design. Data were collected through questionnaires from 80 healthcare workers across 10 hospitals in Northern, Middle, and Southern regions. Quantitative data was analyzed using frequencies and percentages. The research revealed that although some hospitals had implemented HIS, there was inadequate training for healthcare workers. While data protection measures were in place, challenges included limited internal system communication, hindering effective HIS operation within hospitals. Additionally, poor internet connectivity and electricity supply hindered HIS usage and adoption. This study contributes by uncovering specific challenges in HIS implementation within Ghanaian hospitals, emphasizing the need for enhanced training, internal system communication, and addressing infrastructure limitations.

An organization must assess the efficacy of its implemented performance measures. SoE Regional General Hospital is a local government agency specializing in public health services. This study endeavors to evaluate the performance of SoE Regional General Hospital (RSUD) by applying the Balanced Scorecard methodology. It was a descriptive quantitative study involving 81 respondents (54.9% female, 45.1% male), with a sample of 72 employees (72.8% female, 27.8% male). The findings indicate that RSUD SoE achieved a total performance measurement score of 0.6, categorizing it as 'good'. Specifically, revenue growth is observed from the financial perspective, albeit not reaching the target; expenditure costs remain within budget, and annual SILPA is reported. Customer satisfaction stands at 64.6%, representing a positive outcome in the customer perspective. Innovations in operational processes are evident in the internal business perspective, though inpatient service indicators fall short of Ministry of Health standards. Regarding growth and learning, employee satisfaction reaches 70.8%, with regular training programs and a favorable retention rate, indicating a conducive environment for employee productivity. Overall, the Balanced Scorecard assessment places the performance of the state-owned hospital within an acceptable range, indicating satisfactory performance levels.

This study aims to investigate the effect of consolidation on the performance of Krakatau Medika Hospital below a group called Indonesia Healthcare Corporation (IHC). The concept of consolidation in the healthcare sector is the focus of the study due to the lack of research that examines this phenomenon in depth. The data used includes several hospital performance indicators, such as operational efficiency, service quality, finance, and other important aspects. By using Balance Scorecard and paired Friedman test, the study reveals that even though the score of performance from the Balance Scorecard gradually improved after the consolidation, the significance of the analyzed data is below 0.05, indicated that there are no remarkable impact of consolidation towards the hospital’s performance. It is advised to take more time to do in-depth research to see how the consolidation actually impacted the hospital.

Providing a favourable practice environment has been regarded as an essential to improve the job outcomes of newly graduated nurses (NGNs). However, little is known about how and when NGNs can best utilize their practice environment to produce optimal job outcomes. The aim of this study, which is based on the Conservation of Resources Theory and the Social Cognitive Model of Career Self-Management, is to investigate whether NGNs who have a higher level of personal growth initiative are more likely to benefit from their practice environment and achieve better job outcomes by increasing their occupational self-efficacy. A cross-sectional study. From 1 September 2022, to 30 September 2022, 279 NGNs from five Chinese state-owned hospitals were recruited for this study. The participants completed measures of practice environment, personal growth initiative, occupational self-efficacy, job stress, job satisfaction, turnover intention and quality of care. A descriptive analysis and a moderated mediation model were computed. Reporting adhered to the STROBE statement. The influence of the practice environment on job outcomes was significantly mediated by occupational self-efficacy, with personal growth initiative acting as a moderator of this mediation effect. NGNs who exhibited a higher degree of personal growth initiative were more likely to derive benefits from their practice environment and attain positive job outcomes by enhancing their occupational self-efficacy. To boost NGNs' occupational self-efficacy and achieve optimal job outcomes, hospital administrators may not only provide a supportive practice environment for them but also conduct interventions that promote their personal growth initiative. This study was designed to examine the psychosocial factors associated with NGNs' job outcomes. The study was not conducted using suggestions from the patient groups or the public. Our findings indicate that favourable practise contexts may not always benefit the nursing job outcome if NGNs do not exhibit a high level of personal growth initiative and produce increased occupational self-efficacy. Therefore, hospital administrators should consider implementing an intervention to improve the personal growth initiative of NGNs so that they can take full advantage of the practice environment and gain resources at work to create optimal job outcomes.

BACKGROUNDHemorrhoidal disease (HD) is considered a low-severity pathology by both general population and physicians, but the lengthy conservative therapy and postoperative complications suggest otherwise.AIMTo assess the effectiveness of different treatment options, both conservative and surgical, in contrast with some preexisting comorbidities.METHODSWe conducted a retrospective, 10-yearlong study between January 2011 and December 2021 in two surgical centers, a private and a state-owned hospital. We compared the efficacy and safety of several treatment options, such as open hemorrhoidectomy, stapled hemorrhoidopexy, rubber band ligation and infrared coagulation in terms of complication rates and types and their correlation with different preexisting comorbidities such as inflammatory bowel disease (IBD), use of anticoagulant medication (AM) and liver cirrhosis. We also conducted a 20-years long PubMed research (1.263 articles) for relevant comparisons.RESULTSOur study recorded 10940 patients with HD, 10241 with conservative and 699 with surgical treatment. Out of these, the male-to-female ratio of 1.3, and a peak in age distribution between 59 and 68 years old (32% of patients). For the entire study, we recorded a 90% incidence of immediate pain, immediate bleeding in 1.5% (11 cases), delayed bleeding in 1.0% (7 cases), and 0.6% surgical site infections. Urinary retention was also present, with 0.2% of patients, anal stricture in 1% and fecal incontinence for 0.5% of patients (4 cases). We recorded no severe complications such as Fournier`s gangrene or rectovaginal perforations. IBD accounted for 6% of the patients, with ulcerative colitis in 12% and Chron`s disease in 10.5%. 6.6% of the patients had AM, determining 4% immediate and 2% delayed bleeding, in surgically treated patients.CONCLUSIONOur study determined that most common complications (pain, urinary retention, bleeding, and stricture) are correlated with each surgical technique and pre-existing comorbidities.

IMPACT This article has multiple implications for state-owned hospitals. The authors show that state-owned hospitals will try to meet the financial targets required by the supervisory authorities. When the central government expects a certain financial outlook, hospitals will manage their accounts to comply with these expectations. Oversight authorities and legislators need to be aware of this tendency and its implications for audits. The article identifies the factors that affect the manipulation of earnings so that strategies can be set to predict and avoid such behaviours.

Management of hospital with state-owned assets lies in the reconstruction of state-owned assets professional operation performance evaluation system. The professional operation of state-owned assets management and operation of hospitals will promote the comprehensive transformation of state-owned assets management function, from the material form of hospital management to the value form of asset control. The management of state-owned hospitals focuses on the real economy and separates the management of state-owned assets from the benefit of state-owned hospitals. Starting from the goal of specialized management of state-owned assets, this paper puts forward the thoughts and principles of selecting performance indicators of specialized management of state-owned assets, and constructs the performance evaluation index system of specialized management of state-owned assets.

To evaluate the use of external cephalic version (ECV) in Portuguese public hospitals with maternity services, as well as exploring the main motives for not offering the technique. A cross-sectional observational study was conducted involving an online survey with 34 questions, accessed via an email addressed to all Heads of Department of Portuguese state-owned hospitals with maternity services. In centers where the technique was performed, information was requested on success rates, contraindications for the procedure, and practical aspects related to its use. In centers where ECV was not offered, the underlying reasons for this were queried. Answers were received from 41 out of the 43 state hospitals with maternity services (95.3%). Sixteen hospitals perform the technique (39%), with reported annual numbers ranging from 3 to 51, and success rates ranging from 25% to 85% (12 respondents). The main reasons for not offering the technique were lack of experience and lack of conditions to perform it safely. Most centers (87.8%) reported that they would welcome hands-on training in ECV. ECV is used in a minority of Portuguese state-owned hospitals. Efforts are needed to achieve a wider implementation of the technique, with a particular focus on simulation-based training.

Modern hospitals base their management systems on the division of policies and affairs, administration and practice. The state-owned hospitals become the juristic persons which possess the independent property ownership, franchise, personnel autonomy, right of salary assigning and KPI assessing and etc. By means of which, the government grants adequate autonomy to the hospital management team that features the director of the hospital as the core member. With the above context as the main topic, this paper tends to examine the way to achieve the scientific, efficient and democratic decision-making, further exploring the path to a better optimized management and decision-making system of modern hospitals.

The hospital is one of the businesses engaged in the health sector by emphasizing the products and health facilities that are able to be provided by the hospital. Considering the high level of competition in hospitals in Indonesia, both state-owned and private hospitals, many hospitals have developed marketing strategies to meet sales targets and realize marketing goals. One of them is the Diponegoro National Hospital which runs a Global Innovative Marketing strategy by providing exclusive Private Wing services for special customers or VIPs (Very Important Person). In this case, the researcher reviews the marketing mix of Private Wings Services through seven variables, namely product, price, place, physical evidence, people, promotion, process. The process of collecting data was carried out by in-depth interview techniques and literature studies on several related literatures that were used as research references. The research was conducted qualitatively and the data that had been collected were analyzed descriptively. The results of this study indicate that the promotion and place variables need to be a concern for the Diponegoro National Hospital in developing Private Wing services.

Objective: To investigate the status quo of human resources of dentists who deal with periodontal disease in Beijing area through an online survey, which may hopefully provide a preliminary basis for the decision-making of administrative departments and the formulation of periodontal professional development plan. Methods: The dentists who deal with periodontal disease at least half a day per week in Beijing area were investigated. A questionnaire was designed by the chairman of the Periodontology Committee of Beijing Stomatological Association. The questionnaire was sent to and finished by the dentists via "WenJuanXing" online survey software. The contents of the survey included general condition, the property of practice unit, title and position of the dentist, membership of professional society, time and content of periodontal treatment, adoption of new technology and new method of periodontal therapy during the past one year, status of periodontal treatment in the local population and reasons, understanding and influencing factors of periodontal professional development. Results: A total of 1 255 dentists completed the survey, who came from all 16 districts in Beijing, mainly Haidian, Chaoyang, Dongcheng and Xicheng Districts [The total percentage of these four main districts was 70.3% (882/1 255)]. The mean age of the dentists was (36.1±8.3) years. Among the dentists, 71.1% (892/1 255) were females, 88.1% (1 106/1 255) got a Bachelor's degree or above. It was estimated that 35.4% (444/1 255) of the dentists had received standardized periodontal training ever. The percentage of dentists carrying out new technology in the past one year was as high as 68.1% (855/1 255). There were only 163 periodontal specialists (13.0%) out of the dentists in the survey. Only 15.9% (200/1 255) of the dentists routinely performed periodontal surgery. The majority of the dentists [82.8% (1 039/1 255)] were from the state-owned hospitals. Fifty-four point seven percemt (686/1 255) of the dentists thought that lack of knowledge was the main reason why the general public failed to receive periodontal treatment. As for the biggest bottleneck affecting periodontal professional development, fifty-one point zero percent (640/1 255) of the dentists attributed it to the public neglect. Conclusions: The periodontal practitioners in Beijing are young, highly educated, unevenly distributed in 16 districts and mostly females. State-owned oral health institutions are an important force in periodontal diagnosis and treatment services in Beijing. The number of periodontal specialists need to be improved. Promotion of standardized periodontal surgery and the popularization of healthcare knowledge on periodontal disease should also be the focus in the future.

Purpose: This paper aims to scrutinize the healthcare service quality in the rural population of a developing economy like India. It further aims at analyzing the service quality gap of the healthcare sector as perceived by its customers. 
 Design/ Methodology/Approach: This paper used the SERVQUAL model to examine the service quality of the health care units. For this study, only public health care units from the rural areas were considered.
 Findings: The results entail that the hospitals have little or no provision of necessary infrastructural facilities inside the hospital in terms of medical equipment. The healthcare personnel do not provide personalized attention to the patients. Research
 Limitations: The study was limited to rural state-owned hospitals' status; the results and interpretations may not be completely applicable or relevant to the private sector hospitals and urban hospitals.
 Practical Implication: The study clearly states that the patients know their expectations in terms of service quality.
 Originality/ Value: Vivid research has been done to examine the quality of services provided by the healthcare units, the least of them focusing on the rural front. This study is a genuine work by the authors to understand the healthcare providers' rural population's expectations.

The electronic health record is a growing concept that facilitates the use of standardized documentation, to improve the quality of care given to patients. This study assesses the perceptions and plausible barriers to the proper integration of the electronic health record among nurses in University College Hospital and Adeoyo Maternity Teaching Hospital, both located in Ibadan, Oyo State, in the Western part of Nigeria. The level of association between variables (age, level of academic qualification, and work experience) and nurses' perceptions of electronic health record was also tested. This was a descriptive cross-sectional study that used a simple random sampling technique to recruit 384 nurses, who completed a well-structured questionnaire. Approximately 57.0% of the respondents held poor perceptions of electronic health record integration. Barriers included poor electricity supply, lack of Internet connectivity, and infeasibility of electronic health record integration. An association between level of academic qualification, work experience, and participant perceptions about electronic health record integration was not found (P = .104; P = .027), whereas age was statistically significant (P = .014). Overall, participant perceptions about the integration of electronic health record were poor. Relevant stakeholders would find this result useful and may be required to pay more attention to electronic health records and put the necessary structures that would adequately address the barriers to the integration of electronic health records and train nurses to incorporate the same.

Aim: To examine maternal environmental factors as predictors of the incidence of gastroenteritis among under-five children in Akure South Local Government Area, Ondo State. Materials and Methods: A descriptive study was carried out in two state-owned hospitals between April and August 2019 using a purposive and convenience sample of 120 mothers of under-five children. Data collected were analyzed using PPMC and regression to test the hypotheses at 0.05 alpha level. Results: The study shows that three out of four environmental predictors were potent predictors of the incidence of gastroenteritis. They include: quality of water source (β = .387, t = 7.638, P 0.05) was not a potent predictor. Area of residence, quality of water source, hygienic practices and method of sewage disposal had a significant joint contribution used to predict the incidence of gastroenteritis. Conclusion: Area of residence, quality of water source, hygienic practices and method of sewage disposal all increase the incidence of gastroenteritis when proper attention is not paid to them. Education about handwashing is necessary for mothers and environmental health workers in collaboration with the Ministry of Health, and the Ministry of Environment should ensure that every house has the proper means to dispose of sewage, especially a septic tank (flush toilet); this will help reduce the disposal of feces in the environment.

Compliance with hand hygiene standards remains a challenge to many healthcare workers even though there is adequate scientific evidence supporting its role in improving health provider and patient safety, reducing costs and creating a positive working environment. This article describes factors that contribute to non-compliance with hand hygiene standards among nurses in Windhoek, Namibia. A non-experimental, quantitative descriptive and cross-sectional design was utilised. The target population consisted of nurses working at one state-owned hospital in Windhoek. A probability, stratified random sampling method was used to select a representative sample of 170 nurses from three categories of nurses, namely registered nurses, enrolled nurses and auxiliary nurses. A self-administered questionnaire was used to collect data, which were analysed by using SPSS version 23.0. According to the results, there were more institutional than personal factors that contribute to non-compliance with hand hygiene standards among the nurses. Institutional factors included inadequate resources for hand hygiene, the absence of role models such as colleagues and supervisors, workshops, seminars and continuing educational courses on hand hygiene as well as the absence of incentives or encouragement for compliers and sanctions against non-compliers with hand hygiene standards. The key recommendations included organisational commitment to hand hygiene, the creation of an organisational climate and culture that support hand hygiene, supervision and monitoring of hand hygiene, the supply of hand hygiene agents that do not cause skin dryness, and in-service education that focuses on hand hygiene.

The relevance of language for quality healthcare delivery cannot be overemphasised. Within the framework of communication accommodation theory, this paper discusses language barriers in expatriate doctor-patient communication in three state-owned hospitals in Ghana, and the strategies employed by the medical personnel to bridge communication gaps. The study design is qualitative and the data were obtained through semi-structured interviews with 16 expatriate doctors, three nurses and three patients. Furthermore, observation of five patient-doctor interactions was undertaken and notes taken. Both datasets were then analysed using the qualitative conventional content analysis approach. The findings revealed that the expatriate doctors employed convergence strategies such as ad hoc interpreters, gestures, picture charts and electronic dictionaries to deal with language barriers. The study is expected to stimulate further research into innovative ways of dealing with language barriers in expatriate doctor-patient interactions.